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General NPI Number Information
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NPI Number | 1104270677
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Entity Type | Organization
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Legal Business Name | COMPLETE FAMILY CARE CENTER, LLC
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 600 WHITNEY RANCH DR SUITE #B-11
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City | HENDERSON
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State | NV
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Zip | 89014-2611
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Country | US
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Telephone | 702-558-6366
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Fax | 702-558-6364
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Provider Business Mailing Address
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Address Line | 600 WHITNEY RANCH DR SUITE #B-11
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City | HENDERSON
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State | NV
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Zip | 89014-2611
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Country | US
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Telephone | 702-558-6366
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Fax | 702-558-6364
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Authorized Official
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Title or Position | CFO
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Name | MR. MARC DAVIS TAYLOR
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Credential |
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Telephone | 212-444-5218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 973DL
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 973DL
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License Number State | NV
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